Ferric Carboxymaltose With or Without Phosphate Substitution for the Treatment of Iron Deficiency or Iron Deficiency Anemia

  • STATUS
    Recruiting
  • End date
    Oct 17, 2024
  • participants needed
    92
  • sponsor
    Donat R. Spahn
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Updated on 7 April 2023
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iron deficiency anemia
iron
anemia
ferric carboxymaltose
ferinject

Summary

This is a confirmatory trial to establish superior serum phosphate stability associated with use of Phoscap® compared with placebo as a supplement for treatment of iron deficiency or iron deficiency anemia with Ferinject® before elective surgery.

Description

Iron deficiency anemia is a global health problem most commonly caused by excessive blood loss, impaired intestinal iron absorption, or chronic inflammation. In the perioperative setting, intravenous ferric carboxymaltose allows efficient treatment of preoperative iron deficiency and anemia. Recent studies have implied that ferric carboxymaltose might cause hypophosphatemia. Notably, hypophosphatemia has been associated with less muscle strength, which may influence early post-surgery recovery of patients. Additional oral phosphate supplementation may alleviate this hypophosphatemia.

This is a confirmatory trial to establish superior serum phosphate stability associated with use of Phoscap® compared with placebo as a supplement for treatment of iron deficiency or iron deficiency anemia with Ferinject® before elective surgery.

This is also a confirmatory trial to establish non-inferior efficacy of Phoscap® compared with placebo for the treatment of iron deficiency or iron deficiency anemia with Ferinject®; and to establish superior core muscle strength associated with the use of Phoscap® compared with placebo.

Details
Condition Anemia, Iron-deficiency, Hypophosphatemia
Treatment Placebo, Verum
Clinical Study IdentifierNCT05098249
SponsorDonat R. Spahn
Last Modified on7 April 2023

Eligibility

 Yes No Not Sure

Inclusion Criteria

Informed Consent as documented by signature (Appendix 5: Informed Consent Form)
Male or female ASA 1 to 3 patients, at least 18 years old
Scheduled for an elective major abdominal or thoracic surgery
Patients with isolated iron deficiency (defined as hemoglobin concentration (Hb) > 130 g/l, and plasma Ferritin < 100 ng/ml or TSAT < 20%), or iron deficiency anemia (defined as Hb 100-130 g/l, and plasma Ferritin < 100 ng/ml or TSAT < 20%)
Patients scheduled to be hospitalized ≥ 3 days

Exclusion Criteria

Patients with known anaphylactic reactions to parenteral iron products. Patients with allergy/hypersensitivity to any contents of Ferinject® or Phoscap®
Patients with iron overload or disturbances in utilization of iron (e.g. haemochromatosis, hemosiderosis)
Patients with ≥3 times increase in aspartate aminotransferase or alanine aminotransferase as per reference range
Patients with excessive blood loss requiring massive transfusion (≥ 10 more red blood cell units)
Patients with known myelodysplastic syndromes
Patients with chronic kidney disease with an estimated GFR < 30 ml/min or with end-stage renal disease requiring scheduled dialysis
Patients with known urinary tract infections with urea-splitting bacteria
Patients with known diseases influencing phosphate, calcium or vitamin D homeostasis (e.g. Hyperparathyroidism, X-linked hypophosphatemia, renal tubular acidosis)
Patients taking medication significantly influencing phosphate, calcium or vitamin D homeostasis (e.g. vitamin D substitution > 800 I.E. per day in the last 4 months, pre-existing phosphate substitution, phosphate binders)
Patients with preexisting hypophosphatemia
Any patient judged to lack the ability to give informed consent or perform the trial assessments (e.g. due to dementia, insufficient knowledge of the German language)
Women who are pregnant or breast feeding
Intention to become pregnant during the course of the study
Lack of safe contraception, defined as: Female participants of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases (Female participants who are surgically sterilized / hysterectomized or post-menopausal for longer than 2 years are not considered as being of child bearing potential)
Known or suspected non-compliance, drug or alcohol abuse
Participation in another study with investigational drug within the 30 days preceding and during the present study
Any patient judged by the Principal Investigator or Sub-Investigator to be inappropriate for the trial for any other reason
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